Case-control study.
To investigate the incidence of symptomatic spinal epidural hematoma (SSEH) and recognize its risk factors in a cohort of patients undergoing posterior thoracic surgery in isolation.
From January 2010 to December 2019, patients who developed SSEH after posterior thoracic urgery and underwent hematoma evacuation were enrolled. For each SSEH patient, 2 or 3 controls who did not develop SSEH and underwent the same procedures with similar complexity at the same section of the thoracic spine in the same period were collected. The preoperative and intraoperative factors, blood pressure-related factors and radiographic parameters were collected to identify possible risk factors by comparing between the 2 groups.
A total of 24 of 1612 patients (1.49%) were identified as having SSEH after thoracic spinal surgery. Compared to the control group (53 patients), SSEH patients had significant differences in the APTT (p = 0.028), INR (p = 0.009), ratio of previous spinal surgery (p = 0.012), ratio of cerebrospinal fluid leakage (p = 0.004), thoracic kyphosis (p&lt;0.05), local kyphosis angle (p&lt;0.05), epidural fat ratio at T7 (p = 0.003), occupying ratio of the cross-sectional area (p&lt;0.05) and spinal epidural venous plexus grade (p&lt;0.05). Multiple logistic regression analysis revealed 3 risk factors for SSEH cerebrospinal fluid leakage, the local kyphosis angle (&gt;8.77°) and the occupying ratio of the cross-sectional area (&gt;49.58%).
The incidence of SSEH was 1.49% in posterior thoracic spinal surgeries. Large local kyphosis angle (&gt;8.77°), high occupying ratio of cross-sectional area (&gt;49.58%) and cerebrospinal fluid leakage were identified as risk factors for SSEH.
49.58%) and cerebrospinal fluid leakage were identified as risk factors for SSEH.Retrospective observational study of a cohort of consecutive patients.
Postoperative ileus (POI) is associated with a variety of adverse effects. Although the incidence of and risk factors for POI following spinal surgery have been reported, the frequency and pathology of POI after spinal corrective surgery for adult spinal deformity (ASD) are still largely unknown. The study objectives were to (1) clarify the prevalence and clinical significance of POI, (2) elucidate the risk factors for POI, (3) determine radiographically which preoperative and/or postoperative spinal parameters predominantly influence the risk of POI after spinal corrective surgery for ASD.
We included data from 144 consecutive patients who underwent spinal corrective surgery. Perioperative medical complications and clinical information were extracted from patient electronic medical records. Preoperative radiographic parameters and changes in radiographic parameters after surgery were compared between patients with and without POI. Mtential for occurrence of POI.
These results suggested that LLIF and large corrections in TLK were independent risk factors for POI after ASD surgery. When patients with ASD have large TLK preoperatively, and it is determined that a large correction is needed, physicians must be aware of the potential for occurrence of POI.Analysis of a prospective 2-center database.
Medical comorbidities co-determine clinical outcome. Objective functional impairment (OFI) provides a supplementary dimension of patient assessment. We set out to study whether comorbidities are associated with the presence and degree of OFI in this patient population.
Patients with degenerative diseases of the spine preoperatively performed the timed-up-and-go (TUG) test and a battery of questionnaires. Comorbidities were quantified using the Charlson Comorbidity Index (CCI) and the American Society of Anesthesiology (ASA) grading. Crude and adjusted linear regression models were fitted.
Of 375 included patients, 97 (25.9%) presented at least some degree of medical comorbidity according to the CCI, and 312 (83.2%) according to ASA grading. In the univariate analysis, the CCI was inconsistently associated with OFI. Only patients with low-grade CCI comorbidity displayed significantly higher TUG test times (p = 0.004). In the multivariable analysis, this effevere comorbidities who are able to complete the test.Infant and young child feeding practices remain a public health challenge in India. We determined the socio-demographic risk factors for early initiation, exclusive breastfeeding and prelacteal feeding in the urban slums of Pune city.A cross sectional survey of mother (N=1443) children ( less then 2 years) dyads was performed. Socio-demographic, maternal and child characteristics were recorded. Breastfeeding practices were assessed using WHO indicators. Multiple logistic regression was employed to model associations between socio-demographic factors and breastfeeding indicators.Early initiation was reported by 45.2%, prelacteal feeding by 37.5% and exclusive breastfeeding by 23.7%. Caesarean delivery decreased the odds of early initiation (AOR 0.403; 95% CI; 0.303.-0.536) and exclusive breastfeeding (OR 0.675; 95% CI 0. 478-0.953), while it increased the odds of prelacteal feeding (AOR 3.525; 95% CI 2.653-4.683). https://www.selleckchem.com/products/tiplaxtinin-pai-039.html Delivery in a public health care facility increased the odds of early initiation (AOR 1.439; 95% CI 1.095-1.891) and exclusive breastfeeding (OR 0.514; 95% CI 0.366-0.720), while it decreased the odds of prelacteal feeding (AOR 0.421; 95% CI 0.318-0.559). Odds of early initiation decreased significantly in very low-birth-weight (AOR 0.209; CI 0.76-0.567) whereas, it increased odds of prelacteal feeding (AOR 1.389; 95% CI 0.640-3.019), (AOR 0.483; 95% CI 0.262-0.889). Religion other than Hindu or Muslim, age of the mother between 26-30 years increased the odds of exclusive breastfeeding and parity less then 2 increased the odds of prelacteal feeding.Interventions that address setting specific determinants, focusing on local contexts are essential to improve child feeding practices in urban slums.Prospective study.
Minimally-invasive lumbar fusion surgery (MIS) is a viable alternative to conventional open surgery (COS) for spinal disorders. Although MIS seems to be associated with less para-spinal muscle trauma, the actual back muscle performance after MIS and COS remain controversial. This study investigated post-operative para-spinal muscle performance, and the correlation between muscle dysfunction and clinical outcome.
In this prospective, non-randomized control study, 50 patients were enrolled and split into 2 groups COS and MIS. We established a biomechanical model of the para-spinal muscle in the lumbar spine using electromyography (EMG) and specific muscle function tests. Functional outcomes were also reviewed and analyzed. All patients underwent EMG pre-operatively, and at 3 months and 1 year post-operatively. The para-spinal muscle performance was investigated by comparing the back muscle co-contraction ratio and the load transmission zone to the pre-operative data.
Twenty-one patients in the COS group and 25 in the MIS group completed the study.